Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $234.42 / $812.83	Facility		$181.97	$234.42	$812.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $114.82 / $199.53	Professional		$75.86	$114.82	$199.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $70.79 / $75.86	Professional		$70.79	$70.79	$75.86
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $363.08 / $676.08	Facility		$363.08	$363.08	$676.08
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $125.89	Professional		$30.90	$30.90	$125.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $316.23 / $660.69	Facility		$162.18	$316.23	$660.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $177.83 / $323.59	Professional		$93.33	$177.83	$323.59
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $151.36 / $269.15	Professional		$85.11	$151.36	$269.15
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $10,471.29 / $25,118.86	Facility		$134.90	$10,471.29	$25,118.86
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $141.25	Professional		$112.20	$112.20	$141.25
United Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $141.25 / $295.12	Facility		$67.61	$141.25	$295.12
United Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $85.11 / $177.83	Professional		$58.88	$85.11	$177.83